Chest pain in children

What is chest pain?

Chest pain is any discomfort that a child feels in their upper torso or chest area. It may involve an ache, soreness or discomfort in their:

• chest wall (the skin, muscles or ribs)
• trachea (windpipe) and lungs
• esophagus or diaphragm
• nerves and spinal cord

The pain can be an unpleasant physical or emotional feeling and is usually different for each child.

If a child has chest pain, they may sometimes find it difficult to say or show exactly where it is. This is because the nerves from different parts of the chest cross over each other and enter the spine at different levels. Sometimes the source of the pain is not related to the chest at all.

Common causes of chest pain

Chest pain can have many causes, including:

• costochondritis (pain or swelling between a rib and the breast bone)
• muscle strain or injury
• exercise-induced asthma
• acute bronchitis
• pain from coughing
• pain from repeated vomiting
• gastroesophageal reflux (acid reflux)

Teens can sometimes experience functional or anxiety-related pain. Symptoms include hyperventilation (fast breathing), light-headedness and numbness or tingling around the lips and in the hands or feet. Despite not having a clear cause, this pain is still real.

How is the cause of chest pain diagnosed?

A doctor will usually diagnose the cause of chest pain based on a description of the pain and by examining your child.

Although rare, the doctor may order some tests, such as an electrocardiogram (ECG), a chest X-ray or blood tests, to help reach a diagnosis.

Be sure to tell your doctor about any family history of:

• sudden, unexplained deaths
• early heart disease
• exercise intolerance
  
• asthma, eczema or allergies
• inflammatory or rheumatic diseases

Taking care of your child with chest pain at home

Treat the pain

Offer your child pain medications such as acetaminophen or ibuprofen. Putting a warm or cool pack to the sore area may help.

Avoid strenuous activity

If the chest pain is caused by muscle strain, your child should avoid strenuous activities and heavy lifting. They can slowly return to activity as their pain eases.

If your child has muscle strain caused by a backpack, you can reduce it with a proper fitting. Your child should carry the backpack on both shoulders, not off to the side.

Further treatment will depend on the cause of the chest pain. Follow your doctor’s instructions.

When to see a doctor

See your child's doctor if:

• the pain is not going away or it continues to affect your child’s daily life
• your child has a fever​ with the chest pain
• your child has a persistent cough.

Go to your nearest Emergency Department or call 911 if your child:

• has pain that comes on suddenly during strenuous activity or occurs with fainting
• feels their heart racing
• becomes dizzy or sweaty with pain
• has trouble breathing, experiences fast breathing or turns blue
• appears more sleepy than usual, is weak or irritable and has a fever